Early glottic carcinoma involving the anterior commissure

Between 1958 and 1990 67 patients with an early glottic carcinoma involving the anterior commissure were treated by radiotherapy. Excluding three with carcinoma in situ, 64 had a T₁N₀M₀ squamous cell carcinoma; in eight of these (12.5%) the tumour was only located in the anterior commissure, in 45 (70.3%) it also involved one vocal cord and in 11 (17.2%) both vocal cords. The overall 5-year survival rate was 85%. For those with only anterior commissure involvement it was 60%, with involvement of one vocal cord and the anterior commissure it was 89% and with involvement of both vocal cords 82%. The 3-year recurrence rate was 58% for patients with involvement of only the anterior commissure, 24% with involvement also of one vocal cord, and 45% for those with involvement of both vocal cords. It was found that in cases of early glottic carcinoma, involving the anterior commissure and treated by radiotherapy, the prognosis for recurrence and survival was poorest when the carcinoma was only located in the anterior commissure, and it was concluded that this group of patients deserves special consideration.     

Three‐Dimensional Vessel Analyses Provide More Accurate Length Estimations than the Gold Standard QCA

Objectives: The aim of this study was to compare lesion dimensions as determined by a three‐dimensional quantitative coronary angiographic (QCA) system to that of a validated two‐dimensional QCA system. Background: In an era of drug‐eluting stents, device sizing has become an important clinical application of online QCA. The CardiOp‐B system integrates two standard angiographic projections to provide a three‐dimensional reconstruction of the arterial segment of interest. Methods: Phase 1 — 47 stenoses from consecutive coronary angiograms were assessed in two projections with both systems providing two data sets for the CMS‐Medis system and a single data set for CardiOp‐B. Phase 2 — a perspex phantom with a known lesion length, was analyzed at increasing degrees of foreshortening with acceptance criteria set at 5% from the absolute value. Results: Phase 1 demonstrated an adequate correlation between the CardiOp‐B and Medis systems when minimal luminal diameter was measured in the optimal view (1.32 ± 0.47 mm vs 1.42 ± 0.49 mm respectively; r = 0.82). A stronger correlation was noted when length was measured (25.27 ± 10.76 mm and 21.32 ± 8.08 mm, respectively; r = 0.95); however CardiOp‐B provided a consistently longer length (P < 0.0001). On phantom length measurements the mean accuracy result for the CardiOp‐B system was ?1.3%. This compared favorably with the two‐dimensional system where all measures performed at greater than 20 degrees of forshortening were beyond the 5% criteria from the known length. Conclusions: Three‐dimensional QCA provides accurate and precise vessel diameter assessments. Length assessments are consistently longer than two‐dimensional measures and are significantly less affected by foreshortened projections. (J Interven Cardiol 2010;23:152‐159)     

INDUCTION OF PSORIASIFORM CHANGES IN GUINEA PIG SKIN BY PROPRANOLOL

Background. The ability of β-adrenergic blocking agents to induce psoriasis as an adverse effect prompted us to use such an agent to induce psoriasis in guinea pigs. Methods. Thirty female albino guinea pigs were divided into four groups. Group 1 received propranolol, 0.1 mg/day, dissolved in 2 mL of normal saline, orally by gavage for 30 days. Group 2 was given the same treatment, but in addition intradermal injections of propranolol with Freund's complete adjuvant, injected at weekly intervals. Group 3 (five animals) received 2 mL saline, and group 4 additional injections of adjuvant without propranolol. Groups 3 and 4 served as normal controls. Results. All animals of group 2 (which received propranolol orally and in addition intradermal injections of adjuvant) developed psoriasiform epidermal hyperplasia with acanthosis. Parakeratosis, papillomatosis, and formation of microabscesses, all characteristic signs of psoriasis, have not been seen in any of the skin samples of this group. Skin samples from group 1 animals receiving propranolol orally showed normal epidermis and dermis. They showed exactly the same histologic picture as the control groups 3 and 4. Conclusions. Beta-blockers given orally for 30 days do not cause any significant skin changes in guinea pigs. When given with a weekly intradermal injection of Freund's complete adjuvant, they cause psoriasiform epidermal hyperplasia. Although the overall histologic appearance of the skin of group 2 resembled psoriasis, it lacked important histologic features characteristic of this disease. It seems, therefore, that the model, per se, does not fulfill the initial expectations as an experimental model for psoriasis; however, this model has potential in the study of adverse drug reactions. Perhaps by introducing modifications to the experimental protocol, we may succeed also in developing a better model for experimental psoriasis.